Comparison of the fecal microbiota of adult healthy dogs fed a plant-based (vegan) or an animal-based diet.

Purpose: Pet guardians are increasingly seeking vegan dog foods. However, research on the impact of these diets on gastrointestinal (GI) physiology and health is limited. In humans, vegan diets modify the GI microbiota, increasing beneficial digestive microorganisms. This study aimed to examine the canine fecal microbiota in response to a vegan diet compared to an animal-based diet. Methods: Sixty-one client-owned healthy adult dogs completed a randomized, double-blinded longitudinal study. Dogs were randomly assigned into two groups that were fed either a commercial extruded animal-based diet (MEAT, n = 30) or an experimental extruded vegan diet (PLANT, n = 31) for 12 weeks. Fecal collections occurred at the start of the experimental period and after 3 months of exclusively feeding either diet. Bacterial DNA was extracted from the feces, and the V4 region of the 16S rRNA gene was amplified using PCR and sequenced on Illumina MiSeq. Beta-diversity was measured using Jaccard and Bray-Curtis distances, and the PERMANOVA was used to assess for differences in fecal microbiota within and between groups. Alpha-diversity indices for richness, evenness, and diversity, as well as relative abundance, were calculated and compared between groups. Results: Beta-diversity differences occurred between diet groups at exit time-point with differences on Bray-Curtis distances at the family and genus levels (p = 0.007 and p = 0.001, respectively), and for the Jaccard distance at the family and genus level (p = 0.006 and p = 0.011, respectively). Significant differences in alpha-diversity occurred when comparing the PLANT to the MEAT group at the exit time-point with the PLANT group having a lower evenness (p = 0.012), but no significant differences in richness (p = 0.188), or diversity (p = 0.06). At exit-timepoint, compared to the MEAT group, the relative abundance of Fusobacterium, Bacteroides, and Campylobacter was lower in the PLANT group. The relative abundance of Fusobacterium decreased over time in the PLANT group, while no change was observed in the MEAT group. Conclusion: These results indicate that vegan diets may change the canine gut microbiota. Future studies are warranted to confirm our results and determine long-term effects of vegan diets on the canine gut microbiome.

Managing the Lactating Patient Receiving Anesthesia: An Innovative Educational Initiative.

Background: Breastfeeding has numerous health benefits for patients and their infants. There are inconsistencies in how anesthesia providers care for lactating patients undergoing anesthesia. Providers may be cautious and have patients "pump and dump" instead of following current evidence-based recommendations. Video-based education provides a novel reference for health care providers in their fast-paced work environments. This project evaluated the effectiveness of an online video module and resources accessed at the bedside for anesthesia providers caring for lactating patients. Materials and Methods: A preintervention survey was sent to anesthesia providers at a large academic institution to assess baseline knowledge of current recommendations for caring for lactating patients having anesthesia. A quick response code-linked video module and references were created and disseminated to all anesthesia providers. A postsurvey was sent to assess knowledge and satisfaction with the educational approach. Postsurvey data were compared with presurvey data. Results: All who watched the educational video found the education helpful to care for lactating patients undergoing surgery. In the posteducation group, 93% of providers selected the correct recommendation to continue breastfeeding or pumping after general anesthesia or sedation once the patient is awake and alert, compared with 48% in the pre-education group. After education, 92% would recommend preoperative feeding or pumping prior to transport to the operating room, compared with the 50% in the pre-education group. Conclusions: Video-based, just-in-time education is an effective way to deliver updated information to anesthesia providers. This format is conducive to just-in-time delivery, and there may be implications for other patient populations that present infrequently but require population-specific care.

Efficacy of vitamin D2 in maintaining serum total vitamin D concentrations and bone mineralisation in adult dogs fed a plant-based (vegan) diet in a 3-month randomised trial.

Dogs are considered omnivores based on their evolution consuming diets including animal tissue. Few feeding trials evaluating the nutritional suitability of exclusively plant-based (vegan) diets in dogs have been published, and the efficacy of vitamin D2 in maintaining canine serum vitamin D levels has not been clearly determined. A blinded dietary trial included sixty-one healthy desexed adult dogs: thirty-one fed an experimental extruded vegan diet (PLANT) and thirty fed a commercial extruded meat-based diet (MEAT) for 3 months. Dogs were screened via veterinary examination and routine laboratory analyses prior to enrolment, at baseline and exit timepoints. Body composition was measured by dual-energy X-ray absorptiometry and blood was collected for vitamin D profiling. All dogs maintained health parameters, body weight and composition throughout the study. Dogs maintained on PLANT demonstrated a significant reduction in platelet count, creatinine, blood urea nitrogen and cholesterol, though values remained within normal reference ranges. Dogs fed PLANT also demonstrated a shift from vitamin D3 to vitamin D2 metabolites, though total vitamin D analogue levels were unchanged, with the exception of 24,25-dihydroxyvitamin D. Bone mineral content and density did not differ from baseline values. Health status was maintained in dogs fed PLANT and vitamin D2 appeared efficacious in maintaining serum total vitamin D concentrations and bone mineralisation. Findings support the hypothesis that PLANT was comparable to MEAT for maintenance of healthy adult dogs for at least 3 months and identified areas where further research is warranted to elucidate the potential risks and benefits of plant-based (vegan) diets.

Qualitative Assessment of Perioperative Lactation Patient Education: "I Think It's Something Women Navigate on Their Own".

Background: Patients who are lactating at the time of a procedure requiring anesthesia benefit from specific education and care coordination to support continued lactation and avoid complications. Before design and implementation of a comprehensive care pathway for this patient population at our institution, we sought to elicit the patient perspective. Methods: We conducted semistructured qualitative interviews with eight patients by phone regarding their experience as a lactating patient presenting for a procedure with anesthesia care at our institution. These were analyzed for predominant themes regarding their experiences. Results: The patients we interviewed reported receiving conflicting information and feeling a sense of uncertainty. Some patients experienced preventable health effects such as mastitis, and prior experience with breastfeeding was protective. The interviewed patients endorsed a desire for structured support and improved education resources. Discussion: This qualitative study of lactating patients undergoing anesthesia and surgery demonstrates a need for coordinated perioperative lactation care. A structured pathway for this patient population with access to updated care guidelines and patient education would be welcomed.

Owner perception of health of North American dogs fed meat- or plant-based diets.

BACKGROUND: Some dog owners elect to feed their dog a plant-based food either as part of or for their entire dietary intake. Being omnivores or facultative carnivores, a strictly plant-based diet is not the natural type of food dogs evolved to consume, leaving some question as to whether this feeding management strategy is safe and healthy for dogs. OBJECTIVES: This study surveyed owner perceptions of health and wellbeing of dogs and compared between those fed meat-based and plant-based diets. METHODS: A web-based questionnaire was distributed to pet owners to collect data on dog characteristics, husbandry, health and wellbeing. Univariate comparisons between diet groups was made by chi square analyses or Kaplan-Meier tests as appropriate, with a significance cut-off value of 0.05. Multivariate models were negative binomial and logistic regression for count and categorical data, respectively. RESULTS: Owners feeding plant-based diets to their dog reported fewer health disorders, specifically with respect to ocular or gastrointestinal and hepatic disorders. Dog longevity was reported to be greater for dogs fed plant-based diets. Owners feeding plant-based diets to their dogs relied less on veterinary associates for nutrition information, versus dog owners feeding meat-based diets. CONCLUSIONS: Dog owners feeding a plant-based diet did not perceive adverse health effects in their dogs. The results might suggest an association between feeding a plant-based diet and perceived health and longevity, however inherent bias and limitations associated with surveys of owner perception must be considered, and objective research is required to determine if plant-based diets truly affect canine health.

Correction: Plant-based (vegan) diets for pets: A survey of pet owner attitudes and feeding practices.

[This corrects the article DOI: 10.1371/journal.pone.0210806.].

A Comparison of Key Essential Nutrients in Commercial Plant-Based Pet Foods Sold in Canada to American and European Canine and Feline Dietary Recommendations.

Plant-based foods intended for feeding dogs and cats are available in Canada, though few studies have examined the suitability of plant-based foods for dogs and cats. All commercial plant-based extruded and wet pet food products available in Ontario, Canada, in 2018 (n = 26) were acquired and analysed for energy, crude protein, crude fat, crude fibre, ash, amino acids, fatty acids, minerals and vitamins A, B12, D2 and D3. Results were compared with recommendations of the Association of American Feed Control Officials (AAFCO) and the European Pet Food Industry Federation (FEDIAF). Thirteen products were labelled for adult canine maintenance, four for canine all life stages, one for puppy growth, two for adult feline maintenance, three for feline all life stages, one for adult maintenance of dogs and cats and two for all life stages of dogs and cats. Four products met AAFCO and one product met FEDIAF nutrient recommendations for canine maintenance. No diets met AAFCO or FEDIAF recommendations for feline maintenance or growth for either species. Nutrients most commonly found insufficient were: sulfur amino acids, taurine, arachidonic acid, EPA and DHA, calcium phosphorus and vitamin D. There were no nutrients unable to be provided from non-animal sources. Compliance with labelling guidelines was also poor, similar to other findings with commercial animal-based pet products. The results from this study indicate areas where producers of plant-based pet foods must improve to meet the industry recommended nutrient profiles and labelling requirements.

Commercial diet recommendations and follow-up for a large breed puppy with an intrahepatic portosystemic shunt.

A 6-month-old, intact male Great Dane dog fed a veterinary therapeutic liver diet was evaluated after diagnosis of an intrahepatic portosystemic shunt and hind limb angular limb deformity to determine appropriateness of diet. Evaluation of the current diet revealed it to be inadequate to meet the nutrient requirements of a large breed puppy. The dog clinically improved following a change in diet. There was no longer any angular limb deformity and no reported neurological signs. This report highlights the importance of appropriate feeding management during growth and demonstrates that although veterinary therapeutic diets may appear to be an appropriate choice initially, they may not be ideal for growing puppies as a long-term feeding option. Key clinical message: An individual approach is key for nutritional management of complicated canine veterinary medical cases and includes consideration of the patient's life stage requirements when modifying nutrient intake to manage clinical disease.

Recommandations alimentaires commerciales et suivi d'un chiot de grande race avec un shunt porto-systémique intrahépatique. Un chien grand danois mâle intact âgé de 6 mois nourri avec une diète thérapeutique vétérinaire à base de foie a été évalué après le diagnostic d'un shunt porto-systémique intrahépatique et d'une déformation angulaire des membres postérieurs afin de déterminer la pertinence du régime alimentaire. L'évaluation du régime actuel a révélé qu'il était insuffisant pour répondre aux besoins nutritionnels d'un chiot de grande race. Le chien s'est amélioré cliniquement suite à un changement de régime. Il n'y avait plus de déformation angulaire des membres et aucun signe neurologique signalé. Ce rapport souligne l'importance d'une gestion appropriée de l'alimentation pendant la croissance et démontre que bien que les régimes thérapeutiques vétérinaires puissent sembler être un choix approprié au départ, ils peuvent ne pas être idéaux pour la croissance des chiots en tant qu'option d'alimentation à long terme.Message clinique clé :Une approche individuelle est essentielle pour la gestion nutritionnelle des cas médicaux vétérinaires canins compliqués et comprend la prise en compte des besoins du patient au stade de la vie lors de la modification de l'apport en nutriments pour gérer la maladie clinique.(Traduit par Dr Serge Messier).

Dexmedetomidine Levels in Breast Milk: Analysis of Breast Milk Expressed During and After Awake Craniotomy.

Background: Dexmedetomidine is an α2-adrenoreceptor agonist with utility in sedation and analgesia for the perioperative or intensive care patient. The literature regarding the safety of dexmedetomidine in lactating patients is very limited. Methods: We present a case of a lactating patient who received dexmedetomidine bolus and infusion as part of her intraoperative sedation during an awake craniotomy. Breast milk samples were expressed by the patient twice intraoperatively and twice postoperatively. All samples collected were analyzed using liquid chromatography mass spectrometry. Results: Dexmedetomidine concentrations in the breast milk were measured at various intervals and were 88 and 50 pg/mL intraoperatively, and 89 and 15 pg/mL postoperatively. Conclusion: Levels of dexmedetomidine in breast milk were exceedingly low. Interruption of breastfeeding and/or discarding expressed breast milk may not be necessary after dexmedetomidine in breastfeeding mothers. Further investigation with a larger sample size is warranted to describe safety profile of dexmedetomidine in breastfeeding infants.

Case Report: Application and Limitations of a Plant-Based Diet Formulated for a Cat With Feline Lower Urinary Tract Disease.

A 2-year-old male castrated domestic shorthair cat was presented for recommendations for dietary management of chronic FLUTD using a strictly plant-based diet as per the stipulations of the cat's owner. The cat had a history of urethral obstruction of unknown etiology, persistent marked struvite crystalluria, and persistent inappropriate elimination. Commercial plant-based products meeting the nutritional recommendations for maintenance of adult cats with the lowest concentration of struvite precursors were identified, but the cat would not eat them. At the request of the client, a homemade plant-based diet was formulated with the intention of increasing water intake and promoting acidic, dilute urine. Urine concentration was able to be decreased somewhat and struvite crystalluria resolved, but the urine remained more alkaline than intended. The cat clinically improved and no further FLUTD episodes were reported by the client.

Pregnancy and Motherhood for Trainees in Anesthesiology: A Survey of the American Society of Anesthesiologists.

BACKGROUND: Although approximately half of US medical students are now women, anesthesiology training programs have yet to achieve gender parity. Women trainees' experiences and needs, including those related to motherhood, are increasingly timely concerns for the field of anesthesiology. At present, limited data exists on the childbearing experiences of women physicians in anesthesiology training. METHODS: In March of 2018, we surveyed women members of the American Society of Anesthesiologists via email. Questions addressed pregnancy, maternity leave, lactation, and motherhood. We analyzed data from a subset of respondents who were pregnant or had children during training and graduated in the year 2000 or later. RESULTS: A total of 542 respondents who completed training in the year 2000 or after reported 752 pregnancies during anesthesia training. A maternity leave had a median length of 7 weeks and did not change significantly over time. During many pregnancies, women felt their leave was inadequate (59.6%) or felt discouraged from taking more time off (65.7%). Pregnancy and associated leave extended graduation from training in 64.1% of cases. In approximately half of pregnancies (51.3%), women met desired breastfeeding duration, with access to designated lactation space decreasing significantly over time (false-discovery adjusted P = .0004). Trainee mothers often felt discouraged from having children (51.6%) or perceived negative stigma surrounding pregnancy (60.3%). These attitudes did not change over time or in relation to female program leadership. CONCLUSIONS: Women anesthesiology trainees commonly face obstacles when attempting to balance work and motherhood. Recent policy changes have addressed some of the challenges identified in our study. Future studies will need to evaluate how these changes have impacted anesthesiology trainees.

A cross-sectional study of owner-reported health in Canadian and American cats fed meat- and plant-based diets.

BACKGROUND: Cats, being obligate carnivores, have unique dietary requirements for nutrients most commonly found in dietary ingredients of animal origin. As such, feeding a diet devoid of animal-derived ingredients has been postulated as a possible cause of nutrient imbalances and adverse health outcomes. A small proportion of cat owners feed strictly plant-based diets to the cats in their care, yet the health and wellness of cats fed these diets has not been well documented. RESULTS: A total of 1325 questionnaires were complete enough for inclusion. The only exclusion criterion was failure to answer all questions. Most cats, 65% (667/1026), represented in the survey were fed a meat-based diet and 18.2% (187/1026) were fed a plant-based diet, with the rest fed either a combination of plant-based with meat-based (69/1026, 6.7%) or indeterminable (103/1026, 10%). Cat age ranged from 4 months to 23 years, with a median of 7 years, and was not associated with diet type. No differences in reported lifespan were detected between diet types. Fewer cats fed plant-based diets reported to have gastrointestinal and hepatic disorders. Cats fed plant-based diets were reported to have more ideal body condition scores than cats fed a meat-based diet. More owners of cats fed plant-based diets reported their cat to be in very good health. CONCLUSIONS: Cat owner perception of the health and wellness of cats does not appear to be adversely affected by being fed a plant-based diet. Contrary to expectations, owners perceived no body system or disorder to be at particular risk when feeding a plant-based diet to cats. This study collected information from cat owners and is subject to bias, as well as methodological limitations. Further research is warranted to determine if these results are replicable in a prospective investigation.

Abnormal bone mineralization in a puppy fed an imbalanced raw meat homemade diet diagnosed and monitored using dual-energy X-ray absorptiometry.

A 4-month-old male Old English Sheepdog was presented for evaluation of a raw meat-based homemade diet after a 1-month history of progressive lameness. Marked dietary deficiencies were detected, which included calcium, phosphorus and vitamin D. Hypovitaminosis D and hypocalcaemia were diagnosed by serum analysis. Evidence of severe diffuse osteopenia was noted on survey radiographs. Dual-energy X-ray absorptiometry (DEXA) was used to quantify bone mineral content and density and compare to published reference ranges. The puppy's initial bone mineralization was markedly subnormal, with bone mineral density 66% lower than expected, and bone mineral content 40% lower than expected. Subsequent DEXA scans were performed at intervals during the puppy's recovery to document the rate of bone re-mineralization and guide therapeutic recommendations. Marked improvement was achieved within 4 months through exercise control and feeding of a diet appropriately formulated for large breed puppy growth and development. This report reinforces the necessity of thorough dietary history and highlights the potential for malnutrition in pets fed homemade and raw meat-based diets. Use of DEXA has rarely been reported in clinical cases, yet can be a valuable tool for diagnosing and monitoring cases with abnormal bone mineralization. Further studies using DEXA to track bone mineralization in healthy puppies are encouraged to develop a more robust reference range of bone mineralization in growing dogs of varying sizes, weights and ages.

An observational study of pet feeding practices and how these have changed between 2008 and 2018.

BACKGROUND: Pet owners have many feeding options, some may be considered unconventional by veterinary practitioners. Provision of appropriate nutrition is a basic requirement, with adverse health outcomes possible when a pet diet is inadequate. OBJECTIVE: To capture dog and cat feeding practices, with a special focus on countries with large English-speaking populations, and to compare with data published over the previous 10 years. METHODS: An electronic questionnaire was provided for dog and cat owners online. Responses were analysed using descriptive statistics, and comparisons made with data from nine peer-reviewed articles published over the previous 10 years. RESULTS: Responses from 3673 English-speaking dog and cat owners in Australia, Canada, New Zealand, the UK and the USA were included. In previous publications, conventional (commercial, heat-processed) products were the predominant method of feeding. In recent publications, feeding unconventional (raw, homemade, vegetarian) diets appeared more prevalent. In the present study, most (79 per cent dogs, 90 per cent cats) pets were offered conventional food. However a few (13 per cent dogs, 32 per cent cats) pets were fed conventional foods exclusively. Many pets were offered homemade (64 per cent dogs, 46 per cent cats) and/or raw (66 per cent dogs, 53 per cent cats) foods. Different feeding practices were associated with geographical location. CONCLUSION: As an increased risk of nutrient insufficiency and associated conditions have been attributed to unconventional feeding practices, veterinarians must be aware of pet feeding trends and educate clients about the nutritional needs of companion animals.

Motherhood and Anesthesiology: A Survey of the American Society of Anesthesiologists.

BACKGROUND: The proportion of women medical school graduates in the United States has grown substantially; however, representation of women in anesthesiology lags behind. We sought to investigate factors associated with women recommending against a career in anesthesiology due to obstacles related to motherhood. METHODS: We surveyed 9525 women anesthesiologist members of the American Society of Anesthesiologists (ASA) with a web-based survey distributed via e-mail. Associations between whether women would counsel against anesthesiology due to obstacles related to motherhood and 34 related categorical variables were estimated. Fisher exact test was used for categorical binary variables, and Wilcoxon-Mann-Whitney test was used for ranked variables. RESULTS: The response rate for the primary question was 19.2%. Among the 1827 respondents to the primary question, 11.6% would counsel a female medical student against a career in anesthesiology due to obstacles pertaining to motherhood. Counseling against an anesthesiology career was not associated with ever being pregnant (P = .16), or whether a woman was pregnant during residency or fellowship training (P = .41) or during practice (P = .16). No association was found between counseling against anesthesiology and training factors: total number of weeks of maternity leave (P = .18), the percentage of women faculty (P = .96) or residents (P = .34), or the number of pregnant coresidents (P = .66). Counseling against a career in anesthesiology was significantly associated with whether respondents' desired age of childbearing/motherhood and desired number of children were adversely affected by work demands (with Bonferroni adjustment for the 34 comparisons, both P < .0001). The risk ratio of respondents whose desired childbearing age and desired number of children were affected by work demands counseling against a career in anesthesiology was 5.1 compared to women whose desired childbearing age and desired number of children were not affected (99% confidence interval [CI], 3.3-7.9; P < .0001; odds ratio, 6.2). CONCLUSIONS: In this study of 1827 women anesthesiologists, approximately 1 in 10 would counsel a student against a career in anesthesiology due to obstacles pertaining to motherhood, and this was associated with altering one's timing and number of children due to job demands. Further research is needed to understand how women's perception of a career in anesthesiology is related to factors influencing personal choices. Understanding women's perceptions of motherhood in anesthesiology may help leaders support career longevity and personal satisfaction in this growing cohort of anesthesiologists.

Pilot Survey of Female Anesthesiologists' Childbearing and Parental Leave Experiences.

While the literature regarding physicians' childbearing experiences is growing, there are no studies documenting those of anesthesiologists. We surveyed a convenience sample of 72 female anesthesiologists to obtain pilot data. Sixty-six women completed the survey (91.7% response rate), reporting 113 total births from before 1990 to present. Of all birth experiences, proportions of respondents reporting parental leave, lactation facilities, and lactation duration as adequate were 52.3%, 45.2%, and 58.3%, respectively. Most mothers (51.8%) gave birth to their first child while they were trainees. The majority (94.9%) favored an official statement supporting parental leave. These results may serve as groundwork for larger studies.

Catecholamine and Metanephrine Levels in Breast Milk Before and After Paraganglioma Resection.

Background: Catecholamine and metanephrine transfer into breast milk in the setting of secreting paraganglioma or pheochromocytoma has not been previously described. Materials and Methods: We present an investigation in which we measured catecholamine and metanephrine levels in the breast milk in a single patient undergoing resection of a paraganglioma at 5 weeks postpartum. Results:As expected, levels were elevated preoperatively and decreased rapidly after resection. Conclusion:This information may be clinically relevant for patient management when pheochromocytoma or paraganglioma resection is delayed with respect to the delivery of the infant or in the postoperative monitoring of the patient's status.

Plant-based (vegan) diets for pets: A survey of pet owner attitudes and feeding practices.

People who avoid eating animals tend to share their homes with animal companions, and moral dilemma may arise when they are faced with feeding animal products to their omnivorous dogs and carnivorous cats. One option to alleviate this conflict is to feed pets a diet devoid of animal ingredients-a 'plant-based' or 'vegan' diet. The number of pet owners who avoid animal products, either in their own or in their pets' diet, is not currently known. The objective of this study was to estimate the number of meat-avoiding pet owners, identify concerns regarding conventional animal- and plant-based pet food, and estimate the number of pets fed a plant-based diet. A questionnaire was disseminated online to English-speaking pet owners (n = 3,673) to collect data regarding pet owner demographics, diet, pet type, pet diet, and concerns regarding pet foods. Results found that pet owners were more likely to be vegetarian (6.2%; 229/3,673) or vegan (5.8%; 212/3,673) than previously reported for members of the general population. With the exception of one dog owned by a vegetarian, vegans were the only pet owners who fed plant-based diets to their pets (1.6%; 59/3,673). Of the pet owners who did not currently feed plant-based diets but expressed interest in doing so, a large proportion (45%; 269/599) desired more information demonstrating the nutritional adequacy of plant-based diets. Amongst all pet owners, the concern most commonly reported regarding meat-based pet foods was for the welfare of farm animals (39%; 1,275/3,231). The most common concern regarding strictly plant-based pet foods was regarding the nutritional completeness of the diet (74%; 2,439/3,318). Amongst vegans, factors which predicted the feeding of plant-based diets to their pets were concern regarding the cost of plant-based diets, a lack of concern regarding plant-based diets being unnatural, and reporting no concern at all regarding plant-based diets for pets. Given these findings, further research is warranted to investigate plant-based nutrition for domestic dogs and cats.